You experience a pounding heart, sweaty palms, and dizziness. What do you think of? Are you frightened? Do you think you’re going crazy?

People who get scared when they have these symptoms — even if the cause is something as mundane as stress, exercise or caffeine — are more likely to develop a clinical case of an Anxiety Disorder, such as Post Traumatic Stress Disorder, or Panic Disorder, according to recent research. The chronic fear of these kinds of symptoms is a condition called Anxiety Sensitivity.

Those of us with Anxiety Disorders — and those of us without — can become hyper-aware of bodily sensations that lead to anxiety. When this awareness becomes morbid and takes over our lives, it can easily be labeled Anxiety Sensitivity.

Anxiety Sensitivity is a concept introduced in the 1980’s which has attracted a great deal of attention from researchers and clinicians. It is thought to be a preventable precursor to developing Anxiety Disorders, and a treatable condition for those who have already have a disorder.

This article explores Anxiety Sensitivity and its implications for you under the following headings:

What is Anxiety Sensitivity?

Is Anxiety Sensitivity inherited or is it learned?

What is the relationship between Anxiety Sensitivity and Anxiety Disorders?

Treating Anxiety Sensitivity

What Is Anxiety Sensitivity?

Anxiety Sensitivity refers to a person’s tendency to fear anxiety-related symptoms due to the belief that there will be some negative outcome as a result of having those symptoms.{{1}} They perceive their physical responses to certain triggers as a sign of imminent personal harm. They not only fear their reactions, they also fear that other people will detect their anxiety, which only serves to increase their anxiety.{{2}}

These symptoms may be as common as increased heart rate, sweating, muscle tension, headaches, or a sense of unreality in a given situation (derealization).

Anxiety Sensitivity fears lead to unrealistic conclusions:

A person may fear having an increased heart rate because they believe that it will increase their risk for a heart attack or it will lead their having a heart attack.{{3}}

An individual may fear being anxious because they think that others will view them in a negative light.

Sweating or trembling are feared if the person believes these reactions will attract ridicule from others.{{4}}

Someone might fear having the anxiety symptoms of having a headache or difficulties concentrating because they think this is a sign that they are “going crazy.”

A sense of unreality (derealization) is feared if the person believes it is the harbinger of insanity.{{5}}

Is Anxiety Sensitivity inherited or is it learned?

Most researchers believe that Anxiety Sensitivity is a learned response, and is therefore environmentally influenced. However, there have been studies that show that it might be partially inherited from your parents.{{6}} {{7}}

It is generally thought that Anxiety Sensitivity develops from early experiences in a person’s life. For example, a child who sees his or her parents overreact with fear to sickness may begin to believe that certain normal bodily feelings, such as those connected with anxiety, are dangerous and threatening.{{8}}

What is the relationship between Anxiety Sensitivity and Anxiety Disorders?

People with PTSD typically have high levels of Anxiety Sensitivity. Those who develop PTSD as a result of intimate partner violence also usually have higher levels of Anxiety Sensitivity than those who do not develop PTSD. Often, the extent of a person’s Anxiety Sensitivity predicts whether or not they develop more severe PTSD symptoms following the experience of a traumatic incident, such as a motor vehicle accident.{{9}}

Researchers have not discovered why Anxiety Sensitivity increases risk for PTSD. They speculate that fearing anxiety symptoms may cause people to have stronger emotional responses to situations that bring about anxiety, such as traumatic events, thereby increasing the severity of the hyperarousal symptoms of PTSD. As with all the Anxiety Disorders, the fear of Anxiety symptoms causes people to avoid those experiences or feelings that give rise to them. This may put people at risk for developing PTSD because they are not actively confronting and processing their emotions surrounding a traumatic event.{{10}}

Anxiety Sensitivity leads to the avoidance of experiences and feelings that cause anxiety, and this in turn can lead to panic attacks and the development of Panic Disorder. People soon develop a “fear of fear” and may begin to restrict their activities in an attempt to prevent more attacks. While a single panic attack does not indicate development of a psychological disorder — in fact, some estimates indicate that about 20 percent of people will experience a spontaneous panic attack at some point in their lives — repeated occurrences do.

When people start having repeated panic attacks, plus a lot of what we call panic-related worry — they worry when the next attack will occur and they start avoiding things due to worry — this is when someone has panic disorder.

Treating Anxiety Sensitivity

Anxiety Sensitivity is very treatable and can be reduced markedly through the proper treatment. In particular, Cognitive Behavioral Therapy (CBT) has been found to be very effective in reducing Anxiety Sensitivity. Although medications may reduce the immediate effects of Anxiety Sensitivity, the best long-term treatment has been found to be talk therapy, in which a person relearns reactions to common bodily sensations.{{12}} In addition, exposure therapy for PTSD has been found to also reduce a person’s Anxiety Sensitivity. These treatments help people confront and experience their anxiety, allowing them to realize that anxiety is not dangerous and will not have negative consequences (such as having a heart attack or “going crazy”).{{13}} Recent research has shown that Cognitive Behavioral Therapy can be useful in actually preventing PTSD, panic attacks, and Panic Disorder among those with Anxiety Sensitivity. N. Brad Schmidt states:{{14}}

The [research] findings offer an exciting possibility for prevention of anxiety and panic reactions among high-risk individuals… [T]he key is to teach people cognitive and behavioral skills to reduce their anxiety sensitivity so that it does not lead to a serious problem.

What do you think?

It is a hallmark of the Anxiety Disorders that we learn to fear what causes our fear, and increasingly avoid those situations, experiences, and feelings that engender those fears. This builds on itself, soon locking us into a prison of our own making. The predilection to these fears, Anxiety Sensitivity, is an important discovery that can lead to the prevention of the fears, and possibly, the development of Anxiety Disorders themselves.

Have you ever experienced “fear of fear?” What did it feel like?

Do you think the concept of Anxiety Sensitivity is valid in your experience?

Do you think there should be screening for Anxiety Sensitivity for possible proactive treatment?

What can you do now?

You can find several related articles in the “Related Articles” list below. Click on the Categoriestab at the top of the page for a complete list of all articles by category. And in the right sidebar you will find “Browse by Tags,” as well as a Google Custom Search form.

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Hi, your site is great (and I’m not a robot like some of the other commenters!). I’ve had anxiety attacks almost my entire life — in fact, I now believe that my earliest one (I remember being on a playground) was as young as 3 or 4 yrs old, so I definitely think it’s genetic. Sometimes I’ll go years without one, but a traumatic event, death of a family member or breakup absolutely triggers them, sometimes for years. Just getting over a bad 2-year patch after my mom died from cancer. Whew! It manifested as extreme social anxiety. I’ve found that meditation CDs and yoga help IMMENSELY. thank you!

I have been treated with Rx for anxiety for about four years. I recently stopped taking one of the two meds — klonipin. (Withdrawal was not pleasant.) However, I am going back to the psychiatrist for the first time in two years because I find myself avoiding or procrastinating more. I also feeling more anxiety in stressful situations than I did a couple of years ago.

I see the genetic component in my mother and sister, who both have suffered from panic attacks. I haven’t had those — just a general anxiety. Fortunately, since changing careers about 8 years, I find myself less struck and more likely to try new things. I can’t always change myself, but I can change my surroundings to some extent.

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